Opioid overdoses are one of the leading causes of death in the US. A new study has now revealed that the majority of hospital emergency department visits for opioid overdoses involve the use of prescription opioids.
The research letter, published in JAMA Internal Medicine, states that prescription opioids including methadone were responsible for 67.8% of emergency department (ED) visits for opioid overdoses – far more than visits due to heroin, multiple opioids and other unspecified opioids.
According to the Centers for Disease Control and Prevention (CDC), 114 people die as a result of a drug overdose – with another 6,478 treated in EDs for the abuse or misuse of drugs – every day in the US. Drug overdoses are the leading cause of injury death and 9 out of 10 poisoning deaths in the country. In 2012, 72% of pharmaceutical overdoses involved prescribed opioids.
“Opioid overdose exacts a significant financial and health care utilization burden on the US health care system,” write the authors. “Most patients in our sample overdosed on prescription opioids, suggesting that further efforts to stem the prescription opioid overdose epidemic are urgently needed.”
Michael A. Yokell, of Stanford University School of Medicine in California, and colleagues analyzed data from the 2010 Nationwide Emergency Department Sample and defined recorded opioid overdoses with diagnostic codes. In total, they found 135,971 weighted ED visits that were designated as opioid overdoses. These were caused by:
- Prescription opioids (67.8%)
- Heroin (16.1%)
- Unspecified opioids (13.4%)
- Multiple opioid types (2.7%).
The majority of prescription opioid overdoses occurred in urban areas (84.1%). The researchers also found that 40.2% of ED visits for prescription opioid overdoses occurred in the South, and 53% were among women.
Fortunately, the overall death rate was only 1.4% for patients visiting EDs. The authors suggest that this figure supports the increased use of emergency services as a means of dealing with overdoses, illustrating that medical intervention for overdoses is highly effective.
Several co-existing illnesses were found to be shared by many of the patients who presented after overdosing. These included chronic mental health, circulatory and respiratory diseases, leading the authors to recommend health care providers prescribing opioids for these conditions to do so with thorough care and counselling.
The authors observed that around half of the patients in the study sample required hospital admissions after visiting the ED, with the overall costs of ED and inpatient care for these patients totaling almost $2.3 billion.
They also acknowledge that their study does represent all opioid overdoses, as many cases will not be presented to an ED or will result in death before any emergency medical services can be accessed.
The CDC report that in the US, prescription opioid abuse costs were around $55.7 billion in 2007. This amount was comprised of the following:
- Workplace costs, such as lost productivity (46%)
- Health care costs, such as abuse treatment (45%)
- Criminal justice costs (9%).
In 2012, health care providers wrote 259 million prescriptions for opioids – enough for every adult in the US to have their own bottle of pills. In 2010, 1 in 20 people reported using prescription opioids for nonmedical reasons in the past 12 months. Subsequently, the CDC refer to prescription opioid overdoses as “a public health epidemic.”
“These findings suggest that the costs associated with opioid overdose are significant,” conclude the authors. “Strategies to reduce morbidity and mortality resulting from overdose are urgently needed, including enhanced access to substance abuse treatment.”
Previously, Medical News Today reported on a statement from the American Academy of Neurology, in which they asserted that regulations over opioid prescriptions are too permissive and that the adverse effects of opioid painkillers outweigh the benefits to certain patients.